Provider Network Manager

Devoted Health; Pittsburgh (Allegheny County); On-site; USD 80,000 - 100,000; Full time

Job summary

An innovative healthcare company is seeking a dedicated professional to enhance provider networks and improve healthcare delivery for older Americans. This pivotal role involves developing and managing provider relationships, negotiating contracts, and analyzing performance trends to optimize quality and cost. Join a mission-driven team that values compassion and collaboration, where your contributions will directly impact the well-being of members. This position offers a unique opportunity to work in a dynamic environment focused on making a difference in the healthcare landscape. Embrace the chance to grow in a supportive setting that prioritizes your professional development.

Benefits

Employer sponsored health, dental and vision plan

Generous paid time off

$100 monthly mobile or internet stipend

Stock options for all employees

Bonus eligibility for all roles

Parental leave program

401K program

Qualifications

• 5+ years negotiating provider contracts with various payment methodologies.
• Experience in analyzing cost trends and coaching providers.

Responsibilities

• Develop and manage provider networks in the assigned area.
• Negotiate contracts and maintain provider relations.

Skills

Negotiating provider contracts

Provider servicing experience

Analyzing cost trends

Project management

Communication skills

Decision-making

Education

High School Diploma or equivalent

Tools

Google Suite

Microsoft Suite

Job description

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Job Description

Must be located in Western PA Greater Pittsburgh / Greater Erie

A bit about this role:

This is a key role in our organization. The role will be responsible for network development and management along with servicing for an assigned geographic area. The ideal candidate will possess 5+ years experience in recruiting and managing provider networks along with negotiating, reviewing and amending contracts. This experience will include thorough knowledge of contracting with physicians and physician groups, integrated delivery systems, health systems, and ancillary providers using various payment methodologies including fee-for-service and value based / risk. Ideally, the candidate will possess a very high level of business acumen and be able to exhibit it both internally and externally to a wide variety of audiences. Innovation, independence and confidence are key competencies that need to be exhibited.

Your Responsibilities and Impact will include:

• Development, maintenance and management of an adequate provider network in assigned geographical area
• Maintaining relationships and all provider relations activities in assigned geographical area
• Negotiating and renegotiating contracts with providers as assigned
• Engage internal subject matter experts and providers to identify opportunities to improve provider / member cost and quality performance
• Monitoring of various reports to ensure all necessary compliance requirements are met and maintained
• Reporting to leadership current status, risks, and potential opportunities in area of responsibility on a regular basis
• Supporting the overall Network Team as required to achieve success for Devoted Health
• Supporting assigned groups to improve performance in CMS STAR measures
• Analyze cost and performance trends to identify areas for improvement and develop targeted strategies to address variances
• Coach and guide providers on managing costs, improving quality, and optimizing performance within value-based and risk-sharing arrangements.

Required skills and experience:

• 5+ years negotiating provider contracts including physician / provider group contracts with multiple payment methodologies including value based/risk
• Provider servicing experience
• Demonstrated experience analyzing cost trends and coaching providers to improve financial and quality performance
• Ability to manage and prioritize multiple projects simultaneously while meeting deadlines
• Solid ability to navigate either Google or MS Suite of products, including intermediate skills with spreadsheets (pivot tables, vlookups, etc.)
• High School Diploma or equivalent minimum
• Experience in CMS STAR measures
• Experience and relationships in the local market
• Unrestricted driver's license to verify your eligibility and capability to fulfill the driving responsibilities associated with the position

Desired skills and experience:

• Ability to make quick, independent decisions
• Mutually beneficial negotiation skills
• Strong project management skills
• Ability to analyze financial and performance reports and identify trends/variances
• Strong analytical mindset to interpret financial and performance reports, identify trends/variances, and implement solutions.
• Ability to influence providers in improving performance when it comes to cost and quality.
• Ability to manage multiple priorities and deadlines effectively while maintaining attention to detail.
• Extremely effective oral/written communication skills

Salary: $80,000- $100,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program
• And more...

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.